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What clever ideas have you all come up with to keep the max barrier drapes off peoples faces?

We have a metal c-shaped arm that slides underÂ the head of the bed that theÂ top of the drape can be clipped to.Â We've been to theÂ OR for other options, but since many of the PICCs that we place are in patient rooms, the OR options don't adapt to those beds.Â Â I've also thought about alligator clamps on a long chain that would clamp the drape, and then to an IV pole.

WeÂ have a procedure room for outpatients, andÂ the hospital may allow usÂ to have an inpatient procedure room as well, butÂ we're not there yet.Â In the meantime....we're looking for ideas.Â

Today we utilized pillows on the sides at the top of bed to tent the drape off the face. It worked great for an admitted "claustrophobic" patient. We taped the nonprocedure side to an IV pole on another patient with positive outcomes.

IR gave us the c-shaped arm idea; I had a local plumber/metal-worker fabricate one for a prototype. It works pretty well, but it's bulky to carry around.

I've looked in the OR, in OR supply and central sterile supply catalogs - seems like there should be something like the old foot cradles but taller.

I'm looking up dental/medical clamps now (and encountering some interesting websites along the way) - trying to see if we can chain the corners of the towel up with a clamp on either end - to an IV pole. It's not always easy to find IV poles, too - and usually we're wanting to move them away from the procedure area.

I'll keep playing with it and let you know if I come up with anything.

I am not sure if you will agree with this idea or not, but we don't use the fenestrated drape in our kit for that reason, it was hard to keep off our patients faces and sometimes caused severe claustrophobia. We use the long drape to cover up to their chin and place a pack of sterile towels on our field. This pack contains 4 towels and we place one across the forearm stopping just above the AC fossa, one one each side of the arm and the last over the shoulder and neck area covering the patients hair and ears. Works very well and our patients really like it. Draping this way gives us a slightly larger area to work in than the hole in the fenestrated drape for those rare instances where the original place you marked for insertion is unsuccessful and you must move either proximal or distal to your original intened insertion site. We are very careful to prep the entire upper extremity from the AC fossa upward. The towels are very inexpensive and conform to the patients arm much better than the fenestrated drape.

We've used towels occasionally - some clinicians don't like using them, some of us really do like them.

Maximum barrier precautions is head-toe, meaning the entire patient is draped. If there is no way the patient can tolerate head-toe, then what you're doing would work, but only if the patient was wearing a mask. And - some patients can't tolerate masks, either. Another issue is - no matter how alert, well educated about the procedure, and competent the patient is, it's highly likely they'll cough, laugh, or contaminate the sterile field at some point.

I think if we could come up with drape clamps and/or bed cradles - we'd be helping our patients out a lot.

When I place the sterile sheet over the patient, I use the large plastic clamp in our kit to clip part of the sheet that would be covering the patient's face. By doing this I leave only the side of the face opposite the side I am accessing uncovered.

When I do this, it forms a sort of large fan that keeps the patient from being able to turn their head and breathe on my sterile field. I place the handle part of the clamp at the angle of the neck and shoulder and that keeps my clamp vertical and steady.

It's a bit tough to explain, but I hope you can visualize what I am saying. It works very well, and the patients don't mind it at all. Most patients are very anxious about having their faces covered.

What you describe is one of our current techniques (tenting the drape so that the patient's face on the opposite side is open to air, but the drape is tented high enough it protects the procedure side. It's not very stable though; the clamp would help.

First of all, I am NOT a BARD representative in any way shape or form. I j ust use their products. But they DO have a wonderful max barrier kit that was formulated to comply with all the new regs. They have a fenestration on both sides to accomodate either arm. They cover head to toe, and the coolest thing is up at the head, there is a seam that you can tear lengthwise in the middle (from the head down). Then on the side you are working on, you take the drape and tape (tape is part of the drape) it to the head of the bed. The other side of the drape you can move away from the patients face, so their face is exposed. If they turn their head away from you their face is free and clear to the outside of the drape. This is a great product. I don't know if any other companies have such a thing, but it doesn't hurt to ask.

We've been looking at all of them. The problem remains the same, whichever one we've looked at. Sometimes the split drape works, sometimes not so well when the patient is claustrophobic. Sometimes there is a good place to adhere the drape to, sometimes not. My question was not about which drape to use - but about tricks folks came up with for lifting the drape higher off the patient's face, even if it's split and they can see out one side.